Practical Cases- The use of Watson in Hospitals

Glioblastoma, or glioblastoma multiforme, is a malignant, rapidly growing, grade 4 brain cancer whose main symptoms could be headaches, vomiting, seizures or nausea, and can occur in any part of the brain, commonly in the frontal and temporal lobes. Watson is acting in this area of genomics interpreting data from genomic data because is analyzing gene sequence variations between cancerous biopsies and normal to help people with a glioblastoma to live more than the average one year of life predicted, providing personalized treatment, by analyzing amounts of data from clinical records and the medical literature available, and a faster process of decision due to the rapid genome sequencing that Watson can do.

Dr. Robert Darnell, CEO, President and Scientific Director of the New York Genome Center said: “Since the human genome was first mapped more than a decade ago, we’ve made tremendous progress in understanding the genetic drivers of disease. The real challenge has been making sense of massive quantities of genetic data and translating research findings into better treatments and outcomes for patients… Applying the cognitive computing power of Watson is going to revolutionize genomics and accelerate the opportunity to target personalized care for deadly diseases like cancer.”

In the image below is possible to see the detailed information that Watson give from a cell where is possible to analyse the growth factor, transcription factor and other information essential for a good treatment decision from the doctors.

In short, this is a kind of cancer that needs a fast answer because it spread rapidly into other parts of the brain and, in this cases, the time that Watson saves in diagnosing quickly is precious for the life of all the people with this disease.

Memorial Sloan Kettering Cancer Centre is a hospital specialized in the treatment of cancer, located in Manhattan, USA, founded in 1884, the world´s largest and oldest private cancer centre. But what becomes Memorial Sloan relevant here is the significant importance that had “training” Watson in the health area. MSKCC´s agreed to collaborate with IBM to improve the research in cancer area after the success of Watson in Jeopardy, transforming this “game show winner” into a life saver. Today, we are a step closer to answer to the question- How to cure cancer? In reality, MSKCC, a place where works approximately 14.000 physicians, scientists, nurses and other staff, trained Watson in the area of cancer, developing an innovative program that is now expanding to hospitals across the USA and the world. One example are the Manipal Hospitals, in India, a country that in a few years will become the most populated country in the world and where 680.000 died of cancer, in 2014, where the ratio is from 1 oncologist to 1600 patients and 60% of population is unable to access quality cancer treatment. Moreover, 70-80% of the people are diagnosed late, which reduces chances of their survival, what can be avoided with Watson because it is faster than the doctors diagnosing diseases and more correct in some situations.

In the presentation video of IBM explaining how Watson works in this area of oncology, is given us the example of Mrs. Yamato, that discover she has a lung cancer. According to her characteristics and her disease, Watson relate her case with similar cases offering to the doctor different treatment options, the reasons why it put that options (evidence button) and the level of confidence. In few seconds, Watson analyses 3469 textbooks, 69 guidelines, 247460 journal articles, 61540 clinical trials, 106054 other clinical documents. The levels of confidence can be reconsidered because of new events like: do new exams, show her desire to avoid hair loss or new symptoms and it presents new confidence levels that can adapt to her case proving the personalized treatment that Watson allows. This video addresses an important question: the empathy, the emotional intelligence, characteristic of human beings, when she is worried and thinking about how to tell to her children showing the desire to avoid hair loss. In this moment she needs a doctor to comfort her and explain all the possibilities. While Watson do the diagnosis, the doctors can have more time to talk with their patients, improving this essential relation doctor-patient and, because medical data is in an exponential growing, Watson can make better, more personalized and informed decisions.

If you want more information of how to become a patient at MSKCC visit: https://www.mskcc.org/experience/become-patient/faqs-new-patients

Diabetes it is a disease where the body cannot produce enough insulin (type 1 diabetes) or has an inadequate sensitivity of cells to the action of insulin (type 2 diabetes). Another type of diabetes is the gestational diabetes that occurs during the pregnancy where hormones from placenta block the action of the mother´s insulin (insulin resistance) making hard for mother´s body to use insulin. Insulin, produced in pancreas, is a hormone that controls the amount of glucose, the main source of energy for our bodies, in the blood. If a person has diabetes, it means that has too much glucose in the blood, not converting glucose in energy what can cause serious health problems, in the worst cases can cause blindness, limb amputations, stroke, heart attack or kidney failure and dialysis.

IBM is doing several partnerships with companies, for example with Apple, storing and analyzing ResearchKit (open source framework introduced by Apple that allows researchers and developers to create powerful apps for medical research) data; Johnson & Johnson (help develop personalized patient engagement and coaching solutions that span consumer wellness); Under Armor: providing a “Cognitive Training System” that give essential information to athletes about sleep, fitness, activities and nutrition; Medtronic, the partnership that we are going to approach in this article. The incredible capabilities of Watson allow to help some of the people suffering of diabetes. In 1980, there were about 108 million of people with diabetes in the world. In 2014, this number became higher, 422 million, a huge increase. Furthermore, the incidence of diabetes in children (over 18 years) has risen from 4.7%, in 1980, to 8.5% in 2014.

What Watson is doing is crutching the huge amount of data collected by Medtronic – 125 million patient days of anonymous data from insulin pumps and glucose monitors, in other words, the equivalent to 20% of the books in the Library of Congress – and generate knowledge from all of this data what allows the discover of new clues that can help to find a better treatment for diabetes, predict hypoglycemic episodes in diabetic patients approximately three hours in advance what allows to prevent devastating consequences always with one thing that characterize Watson, the personalization of the treatment due to all the capabilities of data analysis from other similar patients and adapting this treatment to the person´s lifestyle. Watson and Medtronic created, in 2016, the Sugar iQ app that help diabetics give them detailed 24 hours statistics with information about the levels of glucose, find hidden patterns in diabetes data what allows, for example, to show how glucose levels are affected by specific food and then people can make better decisions at mealtime.

In conclusion, the improvement of the daily life of diabetics is one more area where Watson is helping and being trained with all this new data from Medtronic showing that partnerships like that are essential and bring benefits for the health of many people.

In 2016, Watson correctly diagnosed a 60-year-old woman with a rare form of leukemia after she had been incorrectly diagnosed with acute myeloid leukemia, which is a type of blood cancer.

After the chemotherapy, the doctors noticed that her recovery from the therapy was slower than the expected, made them believe that she had another type of leukemia.

Tokyo’s Institute of Medical Science decided to use the help of AI Watson that later diagnosed the woman with a rare form of leukemia, which was different from the one doctors originally thought.

In only ten minutes, not only Watson identified the disease by cross-referencing the woman´s genetic changes with 20 million cancer research papers as he filtered out what was diagnostically important and excluding hereditary characteristics that were not related to her disease.

This is a very interesting case because it leaves us wondering how the diagnosis will be made in the future. Are we going to continue to trust a doctor who can take several days to make a diagnosis or a robot that gets more accurate information in just a few minutes?

Since it opened in 2013, Marburg’s Centre for Rare and Undiagnosed Diseases has had more than 6000 patients on waiting list.

The patients who arrive at this hospital often have very long medical histories, some of whom have gone from one doctor to the next for years or even decades without receiving a satisfactory diagnosis.

But since 2016, Marburg Hospital doctors have in Watson a digital assistant that help them explore the causes of these rare diseases more quickly.

The Marburg team tested Watson’s abilities during a twelve-month pilot project, by feeding the system material from already some solved cases.

The performance of Watson convinced the Marburg doctors, who now uses the system for open cases.

In the Marburg Hospital, Watson starts by conducting a text analysis of the patient documentation, using natural speech analysis to not only isolate symptoms but also to understand what medications have already been tried. Along with this analysis, Watson evaluates its available knowledge base – sources such as medical anthologies and databases. Once all this has been done, Watson’s will match diseases and symptoms and will present to the doctor a range of possible diseases and respective treatments.